This striking painting depicts an expression of intense anguish against a dark background, with the central screaming visage surrounded by a chaotic array of nightmarish creatures and objects. The composition explodes outward from the open mouth, with various surreal elements floating in the black space: fish-like creatures with sharp teeth, spiky spherical objects, floating crosses, and abstract organic forms in blues, reds, and grays. The skin tones are rendered in warm flesh colors that contrast dramatically with the dark background. Small white dots and lines scatter across the surface, suggesting a shower of debris or energy emanating from the central figure. The overall effect creates a powerful visualization of inner turmoil and psychological distress, fitting the title's theme of self-inflicted suffering. The painting's style combines realistic rendering with fantastical elements, creating a disturbing dreamlike quality.